Numerous surveys show general confusion among American consumers concerning health insurance. More than half say they feel lost – leading to one in four avoiding the care they need.
If you’ve ever asked yourself, “Why is my health insurance so confusing?” — you’re far from alone. The non-profit KFF found more than one-third (36%) of White and Hispanic insured adults believe it is somewhat or very difficult to understand an Explanation of Benefits (EOB). (That compares to 26% of Black adults.) An EOB is sent after a doctor’s visit or medical treatment. It explains what costs the insurer will pay and what the insured must pay. An EOB is not a formal, final bill.
Thirty percent of those ages 18-29 say it is somewhat or very difficult to understand info about in-network health care providers. An additional 28% of those ages 30-49 also had difficulty. This compares to just 13% of insureds 65 and older.
The Health Insurance Complexity Gap Is Growing
Whether they get coverage through their jobs, the ACA Marketplace, or a state or federal program, many Americans don’t understand what’s covered. Those with Marketplace coverage are most challenged. Forty-six percent are unsure of what their insurance will pay for. For those with employer-sponsored coverage, 40% were unsure. Surprise bills and unexpected out-of-pocket costs are often the result, leaving consumers searching for “health insurance surprise bill help” long after the care is received.
Even among those with more education, many have difficulty understanding their insurance. KFF found 43% of those with a college degree reported confusion understanding their insurance.
As a health insurance broker, you are uniquely positioned help these consumers by offering them information – directly and through their employers.
Tools That Help You Explain Coverage to Clients
You can post useful articles and information on your website, which will help prospects and current customers.
The California Department of Insurance offers a Health Insurance Guide with information to help consumers better understand health insurance. It includes basics like ways to get coverage, types of plans, the benefits of health insurance, info on costs and copays, and what to do if a claim is denied.
Many carriers also offer guides and tools to help you respond to consumer confusion. These resources can help you educate your customers. They can help your clients better understand what to expect after enrolling in health coverage.
Your general agent will likely be able to identify additional useful tools. Word & Brown offers a broad array of forms and guides in our online Insurance Forms Library. Another helpful W&B tool is our unique Compliance Wiki.
How Brokers Build Loyalty Through Client Education
The more you can do to help your clients, their employees, and others understand health insurance, the stronger your bond. And, of course, strong customer relationships lead to increased renewals and future referrals.
If you’re not working with Word & Brown, it’s easy to get started. Visit us online to register or call us at 800-869-6989. Otherwise, reach out to your W&B rep to find out more about the many ways we can help you educate your prospects and customers. We’ve been partnering with brokers for more than 40 years, and we’re known for our Service of Unequalled Excellence.
